Risk factors for preterm birth: a prospective cohort study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of preterm birth and risk factors for preterm birth.@*METHODS@#A prospective cohort study was performed for the pregnant women in early pregnancy and their spouses, who underwent prenatal examination for the first time in Hunan Provincial Maternal and Child Health Care Hospital from May 2014 to December 2016 and decided to be hospitalized for delivery. A questionnaire survey was performed to collect exposure information possibly related to preterm birth. The hospital's medical record system was used for information verification and to record the pregnancy outcome. A multivariate logistic regression analysis was used to investigate the risk factors for preterm birth.@*RESULTS@#A total of 6 764 pregnant women with complete data were included, and the incidence rate of preterm birth was 17.09%. The multivariate logistic regression analysis showed that a history of adverse pregnancy outcomes, eating areca nut before pregnancy, a history of pregnancy complications, a history of hepatitis, no folate supplementation during pregnancy, medication during pregnancy, active smoking and passive smoking during pregnancy, drinking during pregnancy, unbalanced diet during pregnancy, high-intensity physical activity during pregnancy, and natural conception after treatment of infertility or assisted conception as the way of conception were risk factors for preterm birth (@*CONCLUSIONS@#There are many risk factors for preterm birth. Special attention should be paid to the life behaviors of pregnant women during pregnancy, and health education should be strengthened for pregnant women and their spouses to develop good living habits and reduce the incidence of preterm births.

Comparison of Clinical Characteristics and Outcomes of Pediatric and Adult Patients with Coronavirus Disease 2019 in Shenzhen, China / 生物医学与环境科学（英文）

Objective@#Here we aimed to investigate the difference in clinical characteristics and outcomes between pediatric and adult patients with COVID-19.@*Methods@#A total of 333 consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated in the departments of Internal medicine of Shenzhen Third People's Hospital from January 11 @*Results@#Compared with adult patients, pediatric patients had a shorter time of symptom onset to hospitalization than adults [median time, 1 ( @*Conclusion@#Pediatric patients with COVID-19 had milder or less clinical symptoms, less evident pulmonary imaging changes, better prognosis, and shorter length of hospital stay.

Clinical study of application minimally invasive expandable channel in lumbar discectomy and interbody fusion and internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the advantages of minimally invasive expandable in surgery of lumbar discectomy and interbody fusion and internal fixation.</p><p><b>METHODS</b>The clinical data of 48 patients who underwent lumbar discectomy and interbody fusion and internal fixation from January 2010 to March 2016 was retrospectively analyzed. According to the admission queue, the patients were randomly assigned into channel group (26 cases) or traditional group (22 cases). In channel group, surgical approach of minimally invasive expandable channel was applied, and in traditional group, open posterior operation approach (including posterior lumbar interbody fusion and transforaminal lumbar interbody fusion, etc.) was applied. In channel group, there were 20 males and 6 females, aged from 43 to 74 years with an average of(56.6±5.1) years; course of disease was ranged from 4 to 22 months with an average of (6.7±1.8) months; 1 case was complicated with diabetes, 6 cases were complicated with hypertensive disease, and 2 cases were complicated with arrhythmia. In traditional group, there were 15 males and 7 females, aged from 43 to 73 years with an average of(55.9±4.6) years; course of disease was ranged from 4 to 26 months with an average of (6.2±2.1) months; 2 cases were complicated with diabetes, 5 cases were complicated with hypertensive disease, and 1 case was complicated with arrhythmia. Operation time, bleeding volume, and hospitalization time were compared between two groups and visual analogue scale(VAS), Oswestry Disability Index(ODI), bone fusion information, and complications correlated with incision were observed in two groups.</p><p><b>RESULTS</b>All 48 patients were followed up for more than 6 months. Postoperative VAS and ODI were significantly improved (<0.01), but 3 and 6 months after operation, there was no significant difference in VAS between two groups, and ODI score of channel group was lower than that of traditional group(<0.01). Operation time, bleeding volume, hospitalization time in channel group respectively were (167.3±30.2) min, (786.8±147.8) ml, (12.3±2.4) d, and in traditional group were (197.5±48.7) min, (786.8±147.8) ml, (16.5±3.8) d, there was significant differences between two groups. There was no significant difference in fusion rate and fusion time between two groups. There were 4 cases and 7 cases developed incision related complications in channel group and traditional group, respectively. The difference between two groups was significant(<0.01).</p><p><b>CONCLUSIONS</b>Compared with conventional surgery minimally invasive lumbar discectomy and interbody fusion and internal fixation has advantages of less trauma, shorter operative time and better functional recovery.</p>

Treatment of intertrochanteric fractures over age of 80 years old patients with proximal femur intramedullary nail / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of proximal femur intramedullary nail (PFNA) in treating intertrochanteric fracture in elderly patients.</p><p><b>METHODS</b>From January,2008 to December,2010,the data of 86 elderly patients (aged, 80 to 93 years) with intertrochanteric fracture who underwent internal fixation were retrospectively analyzed. Of them, 54 patients (22 males and 32 females) were treated with close reduction and PFNA internal fixation(PFNA group),and 32 patients (12 males and 20 females) were treated with open reduction and nail-plate internal fixation (control group). Operation time, volume of blood loss, postoperative complications, time of hospitalization and bone union, hip function were compared between two groups.</p><p><b>RESULTS</b>All patients were followed up more than 2 years. Operation time, volume of blood loss, postoperative complications,time of hospitalization in PFNA group were less than that of control group (P<0.01). There was no significant difference in time of bone union between two groups (P>0.05). According to Harris score to evaluate the function of hip joint, PFNA group was better than that of control group (P<0.01).</p><p><b>CONCLUSION</b>Treatment of elderly patients with intertrochanteric fractures with PFNA internal fixations can obtain satisfactory results, the method is better than that of traditional method.</p>

Association between blood pressure level and incidence of carotid artery plaque in middle-aged and elderly people / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the association between blood pressure level and incidence of carotid arterial plaque in middle-aged and elderly people.</p><p><b>METHODS</b>A total of 5852 individuals were randomly stratified from the 101 510 health examination survey participants in Tangshan Kailuan Company community during 2006-2007. A total of 5440 people (age above 40 years old, free of stroke, TIA and myocardial infarction) were enrolled in the final analysis. A questionnaire survey, blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. Sixteen individuals without carotid artery plaques information and 35 individuals without blood pressure information were excluded. Finally, a total of 5389 participants [3235 male, mean age: (54.7 ± 11.8) years] were analyzed. According to 2010 Chinese guideline to prevention and treatment of hypertension and blood pressure level classification, participants were divided into normotensive group (n = 1377), high normal blood pressure group (n = 1971) and hypertensive group (n = 2041). Multivariate logistic regression analysis was used to determine the risk factors of the carotid artery plaques.</p><p><b>RESULTS</b>Age, male gender, BMI, IMT, TG, FBG, smoking and alcohol drinking rate were significantly higher in high normal blood pressure group than in normotensive group (all P < 0.05), LDL-C, HDL-C, hs-CRP and TC were similar between these two groups. Incidence of carotid artery plaques in normotensive, high normal blood pressure and hypertensive groups was 24.8%, 37.4%, 60.2% respectively. The risk of carotid artery plaques was increased to 38% and 163% in high normal and hypertensive groups compared to normotensive group, the OR ratio was 1.38 (95%CI: 1.15-1.66) and 2.63 (95%CI: 2.18-3.18), respectively. After adjusting gender, age, smoking, alcohol consumption, TG, TC, HDL-C, FBG, hs-CRP and BMI, the risk of developing carotid artery plague was increased in proportion to increasing blood pressure and the OR value was 1.24 (95%CI:1.01-1.52) , 1.69 (95%CI:1.34-2.15) and 2.66 (95%CI:2.20-3.21) in high normal group I [SBP/DBP 121-129/80-84 mm Hg(1 mm Hg = 0.133 kPa)] and high normal group II (SBP/DBP 130-139/85-89 mm Hg) and hypertensive group, respectively.</p><p><b>CONCLUSIONS</b>The cardiovascular risk factors and prevalence of carotid artery plague increase in proportion to blood pressure level in this cohort. The detection rate of carotid artery plague is already significantly increased in individuals with high normal blood pressure.</p>

Risk early warning and multimodal prevention of postoperative venous thromboembolism for hip fractures / 中国骨伤

<p><b>OBJECTIVE</b>To study the efficacy and safety of multimodal prevention of postoperative venous thromboembolism for hip fractures.</p><p><b>METHODS</b>From March 2009 to July 2011, preoperatively, patients were assigned to two groups on the basis of an assessment of their risk factors. One hundred and twelve patients were considered to be low risk, involving 47 males and 65 females,with an average age of (72.40 +/- 13.29) years ranging from 42 to 88,and were managed with aspirin (100 mg once daily for 14 days) as well as intermittent gasing compression devices. Twenty-six patients were considered to be high risk, involving 12 males and 14 females with an average age of (78.50 +/- 12.76) years ranging from 65 to 84,and were managed with low-molecular-weight heparin (0.4 ml,subcutaneous injection once daily for 14 days) and intermittent gasing compression. All patients were underwent Doppler ultrasonography within 24 hours before hospital discharge. All patients were followed-up for 3 months postoperatively. The incidence of deep venous thrombosis of lower limb, pulmonary embolism, gastrointestinal hemorrhage were recorded.</p><p><b>RESULTS</b>Overall, there were no fatal pulmonary embolism, 1 case of symptomatic pulmonary emboli in low risk group, and none were detected in the high-risk group. Deep venous thrombosis was detected in association with 6 (6.25%) of the 112 procedures in the low-risk group and 2 (7.69%) of the 26 operations in the high-risk group. Paitents were selected in opened reduction and internal fixation, the quantity of bleeding, decrease of hemoglobin, hematoma rate, and gastrointestinal hemorrhage rate of low risk group were (538.10 +/- 390.20) ml, (30 +/- 19) g/L, 0, and 1 (1.03%) respectively; those of the high-risk group were (585.95 +/- 403.96) mL, (32 +/- 20) g/L,1 (4.76%), (4.76%), there were no significant different between the two groups, all P > 0.05.</p><p><b>CONCLUSION</b>There were no statistic significances between the aspirin as well as intermittent gasing compression devices and the low-molecular-weight heparin and intermittent gasing compression in preventing venous thromboembolism (VTE) in postoperative postoperative venous thromboembolism for hip fractures. However, there are potential advantages to reduce complications of bleeding and cardiovascular disease. Multimodal prevention of postoperative venous thromboembolism can protect postoperative patients with hip fractures.</p>

Association between blood pressure level and the development of memory dysfunction in patients with hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>It is known that hypertension may be implicated the development of memory dysfunction. Our study tests the hypothesis that prevalence of memory dysfunction is closely linked with the level of SBP (systolic blood pressure) and DBP (diastolic blood pressure) in hypertension patients.</p><p><b>METHODS</b>Non-stroke hypertension patients aged 18-75 years (n = 196, age 54 ± 10, 101 male) with diagnosed hypertension for more than one year were included. Memory function was measured by the Rivermead Behavioral Memory Test Second Edition (RBMTII, 2003). The general information was obtained through questionnaire.</p><p><b>RESULTS</b>RBMTII total score, the ability of recall name, remember storing article, recall faces, delayed route memory and orientation score were significantly decreased in proportion with increasing blood pressure (P < 0.05: hypertension III vs. II and I). RBMTII total score, the ability of recall name, and recall faces were significantly lower in hypertension II group compared to hypertension I group (P < 0.05). The age, male gender, years of hypertension, level of SBP and BMI were risk factors of memory dysfunction while the years of education was protective factor of memory dysfunction. The morbidity of memory dysfunction in patients with hypertension was higher and more serious with increasing blood pressure level (χ(2) = 10.389, P < 0.01).</p><p><b>CONCLUSIONS</b>Our results suggest that blood pressure is positively related to increased risk of memory dysfunction. The age, male gender, years of hypertension, level of SBP and BMI are risk factors of memory dysfunction while the years of education is protective factor of memory dysfunction.</p>

Protective effects of edaravone on diffuse brain injury in rats / 世界急诊医学杂志（英文）

BACKGROUND: Edaravone can alleviate brain injury and improve neurological functions and symptoms. This study aimed to investigate the effect of edaravone on the p38Mitogen-activated protein kinases/Caspase-3 (p38MAPK /Caspase-3) pathway after diffuse brain injury (DBI) in rats. METHODS: DBI models were established according to the description of Marmarou's method. A total of 250 rats were divided (random number) into four groups: control group (CG, n=45), model group (MG, n=77), low-dose edaravone group (n=67, dosage 5 mg/kg) and high-dose edaravone group (n=61, dosage 10 mg/kg). After 1, 6, 24, 48, and 72 hours after injury, brain tissues were collected. The changes of neuron morphous in the hippocampal region were observed through Nissl staining. The expression levels of phosphorylated p38MAPK and caspase-3 were detected by immunohistochemistry and Western blotting respectively. Learning and memory function were tested with Morris water maze from the 3rd to 7th day after injury. RESULTS: Some neurons had histopathologic changes of necrosis and apoptosis in the model group compared with the control group. The phosphorylated p38MAPK expressions increased at 1, 6, 4, and 48 hours (P<0.05), but no significant difference was observed at 72 hours (0.54±0.19 vs. 0.40±0.14, P>0.05). Caspase-3 expressions increased at 6, 24, 48, and 72 hours respectively (P<0.05), but there was no significant difference at 1 hour (0.59±0.29 vs. 0.40±0.17, P>0.05). From the 3rd to 6th day during the Morris water maze test, the latency to find the platform was significantly prolonged (P<0.05) and times of rats crossing the platform was decreased on the 7th day (2.28±1.18 vs. 8.20±1.52, P<0.05). The phosphorylated p38MAPK expressions decreased at 6, 24 and 48 hours respectively in the low dose edaravone group compared with the model group (P<0.05), whereas no significant difference was seen at 1 hour (1.66±0.80 vs. 1.85±0.86, P>0.05). Caspase-3 expression decreased at 6, 24, 48, and 72 hours (P<0.05). The latency to find the platform was significantly shortened (P<0.05), and times of rats crossing the platform increased (4.17±1.15 vs. 2.28±1.18, P<0.05). The above mentioned parameters changed more significantly in the high-dose edaravone group than in the low-dose edaravone group. CONCLUSION: Edaravone can alleviate brain tissue damage after DBI, inhibit p38MAP signal activation after early injury, reduce the expression of caspase-3, and promote the recovery of neurological function in the late period.

Retrospective analysis of Mr. Xie Xiliang's medical records accumulated in 30 years on direct moxibustion for treating hepatitis B / 中国针灸

To analyze retrospectively Mr. Xie Xiliang's medical records accumulated in 30 years on direct moxibustion for treating hepatitis B, in which 86 cases were included. Before accepting direct moxibustion, 80.23% of the cases had been treated by conventional Chinese and western medicine, but no satisfactory therapeutic effects were obtained. Direct moxibustion was applied for 7-9 cones at each point selected. Point selection was related to ages. Usually, only a few points were used, and Ganshu (BL 18) and Pishu (BL 20) were used as main points. Shenzhu (GV 12) was added for children, and Zusanli (ST 36) added for adults. The improvement rate in clinical symptoms and physical signs were 100%. In the cases with hepatauxe, splenauxe, liver cirrhosis, and abdominal dropsy diagnozed by the B-ultrasonic examination, the improvement was obvious. Of the total, the rates turning to be negative in HBsAg, HBeAg and HBcAb were 28.85%, 38.46%, and 36.54%, respectively. It took some 10 days to 1 month to begin to show improvement in physical signs and hepetic functions, and about 3-6 months for their restoration. For the five items tested in type B hepatitis, it took 5 months to 1 year, even several years, to show their improvement. It is indicated that direct moxibustion is definitely effective in treating type B hepatitis. It is easy to handle and worth popularizing.

Quantitative analysis of the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region / 中华外科杂志

<p><b>OBJECTIVE</b>To study the exposure of suboccipital far-lateral approach and postauricular transtemporal approach to the jugular foramen region based on quantitative measurements, and provide reliable anatomic data for selecting surgical approach individually and protecting the function of important structures.</p><p><b>METHODS</b>The complete approach of the suboccipital far-lateral approach and the postauricular transtemporal approach were reproduced in twelve (twenty-four sides) head-neck specimens of adults be fixed in 10% formalin. The exposure area to the jugular foramen region was obtained using a stereotactic device, and the length of exposure of the clivus and the trigeminal nerve were measured using a vernier caliper.</p><p><b>RESULTS</b>In the suboccipital far-lateral approach, the significant increase in exposure was noted after removal of the jugular process and partial resection of occipital condyle. In the postauricular transtemporal approach, the exposure increased significantly after complete retrolabyrinthine approach, partial labyrinthectomy and transcochlear approach.</p><p><b>CONCLUSIONS</b>Resection of jugular process is the key to expose the jugular foramen through the far-lateral approach. The infralabyrinthine approach and the partial labyrinthectomy approach are ideal approaches to expose the jugular foramen region laterally.</p>

Bromocriptine treatment of invasive giant prolactinomas prior to comprehensive treatments: results of a long-term follow up / 中华外科杂志

<p><b>OBJECTIVE</b>To observe long-term outcomes of patients with invasive giant prolactinomas (IGPs) treated with bromocriptine followed by comprehensive treatments.</p><p><b>METHODS</b>Thirty-four patients met the criteria of IGPs were treated with bromocriptine initially. Among of them, 11 had radiotherapy at the same time. During the treatments, transsphenoidal surgery or/and Gamma Knife were considered to apply to the patients according to the location, shrinkage of residual tumors and resistance of bromocriptine. Small dosage of bromocriptine was kept after operation.</p><p><b>RESULTS</b>The average follow-up duration is 33.6 months. Thirty-three patients obtained significant improvement, but one failed recovery of vision due to side-injury by radiotherapy. Tumor volume on magnetic resonance imaging (MRI) was decreased on average by 91.4%, PRL by 97.1%. The number of patients with low testosterone level restored from 17 to 6 and hypoadrenalism from 10 to 6 after combined treatment with priority of medical therapy. Rhinorrhea occurred in 2 cases, 1 restored in two weeks, 1 had transsphenoidal combined with transcranial surgery to remove the tumor and repair the fistula.4 had resistance to bromocriptine to some extend.</p><p><b>CONCLUSIONS</b>Dopamine agonist medications are effective as a first-line therapy for IGPs. In some patients treated by bromocriptine only, the tumor may disappear on MRI. Combined with surgery and Gamma Knife, the duration of treatment could be shortened and the dosage may be minimized, but using radiotherapy should be cautions.</p>

Co-culture of Schwann cell with fascia / 中国康复理论与实践

@#ObjectiveTo explore the method of co-culture of Schwann cell(SCs) with fascia and provide experimental basis for repairing transected nerve.MethodsSCs were co-cultured with fascia.Double staining by anti-BrdU and anti-S-100,S-100 fluorescent staining and anti-BrdU staining were used.ResultsThere were a plenty of SCs around fascia proliferated rapidly and disposed in parallel. SCs could be distinguished from fibroblastic cells by S-100 fluorescent staining and also be staining positive by anti-BrdU antibody,implying their high proliferous ability. Anti-BrdU and anti-S-100 staining showed numerous double staining positive SCs on the fascia: nucleus was stained deep blue while cytoplasm was stained red.ConclusionMany SCs with high proliferous ability were seen on the fascia, which can be used to repair transected nerve.

Research on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia / 中国康复理论与实践

@#ObjectiveTo observe the effect on repairing facial nerve injury of rabbits by neural stem cells and autologous fasia. Methods22 rabbits with transected facial nerve were divided into 2 groups randomly, control group (8 rabbits,15 sides totally), which transected facial nerve were wrapped by autologous fasia, and treament group (14 rabbits, 20 sides totally), which were wrapped by neural stem cells and autologous fasia. Six weeks after transplantation, neuro-electrophysiological test, immunohistochemical examination were done. The number and thickness of myelin in the re-connected area of transected facial nerve were observed. ResultsThe transplanted animals recovered much better than that in control group (P<0.05). Immunohistochemical examination showed a great deal of BrdU positive cells around the re-connected area of transected facial nerve. Immunohistochemical staining also found plenty of regenerative myelins in this area in the treatment group. While in control group, there were no BrdU positive cells and only a few of regenerative myelins in the same area. ConclusionTransplantation of neural stem cells combined with autologous fasia might become the new method to treat facial nerve injury.